Today I went back to Cambridge to have my tongue examined, wondering throughout the journey which I hate more - the city, or the surgeons?

But now the fact has been confirmed: I hate Cambridge exponentially more than cancer.

Though the surgeon himself was quite jolly and interesting. He says that, in his regional catchment of three million patients, there are about ten of us with the genetic disorder. Since I know (even if he forgets) that myself and possibly one of my children are included in the number, that is a fascinating statistic.

He poked around in the recesses of my mouth for awhile, shrugged, then proclaimed you have some intriguing antique hardware in there.

True! I am quite proud of the fact that I retain possession of a temporary metallic paediatric crown obtained during the first round of surgeries in 1983. It has never been any trouble at all, and I hope it outlasts my corporeal body by centuries.

When I am cremated and put in a vase it will rattle around and remind everyone of all the many tasks and chores and plans I will not be there to prompt.

Or perhaps it could be made into a necklace. The children can argue about who gets to wear it!

Every single doctor who has treated me for the thyroid cancer asks when my exposure to toxic doses of radiation happened. Never if. The answer is: I don't know. Nobody does. Or at least, that information has not yet become publicly available.

Presumably the kids from Chernobyl used different terms for their scars. Several were brought to the NW for treatment and occupied beds in the same cancer ward, but we didn't speak the same language so I couldn't inquire.

Regardless of the source we were sickened by the same substance. Same disease, same risk today, same stupid lies from public health officials.

There is no "safe" level of radiation emission. To "disperse" is not to "eradicate." Nuclear accidents are catastrophic for the immediate residents, rescue workers, and neighbours but also for the entire human population. Radiation is invisible, and it travels.

What is happening right now in Japan is horrifying - the worst nightmare of civilisation come to life.

And even after the immediate danger is contained in that devastated nation, we are all facing an extraordinary risk.

Every day is a party with Byron, but it isn't often I crack out the measuring apparatus and brave the metric system to make him a gluten free cake. Or refrain from screaming and dropping said cake when he blows out all forty candles and splatters my cleavage with hot wax!

What do you buy for the birthday boy who has everything? Hmm. How about. . . obscure and slightly sinister Swiss lamps!

There are no switches or outlets whatsoever in my bathroom, and the lightbulb is protected by impenetrable defences. This is normal in the UK, if annoying, but this week I'm bathing by candlelight because I can't figure out the perverse light fixture.

The punk ethos is largely anti-heroic and as such does a disservice to pioneers and progenitors. We all want to pretend that we are self-invented, lawless, new. But we all have parents and protectors, we all need a place to start. Even if our work is about ripping it all up and starting again.

Olympia has been that place for many musicians, writers, and artists, not because the town is amazing (it is in fact pretty awful) but instead because we went to Evergreen. Or wanted to. Stella was the quintessential Olympia artist-activist and remains one of the very few people I would cite as influential from that scene.

We met over the merchandise tables of one of those large unwieldy events I used to organise in Portland and became fast friends that afternoon. We have remained so as our families and circumstances changed.

We've gone on holidays together, had champagne breakfasts on hidden beaches, celebrated Thanksgiving in several cities. Visits with Stella & Al + Cypress have happened in Olympia, Portland, Seattle, Astoria, Vancouver BC, New York (state and city) and Cambridge England.

Our daughters were little, now they are grown.

The trait I value most in friendship is loyalty, best expressed with continuity. It is easy to lose track of people, very hard to stay in touch, particularly when we all persist in moving around. Stella isn't just an interesting person I know - she is a fine and decent and faithful friend.

It was not only an honour but also excellent fun to spend time together. We have so much in common: a particular history, and similar vocabulary, but also a theoretical framework.

Who else would climb with me to the top of St. Paul's Cathedral to talk about art and revolution?

People like to read about revolutions when they happen safely elsewhere.

Provide material assistance to those who need shelter? Nah.

What, learn from history, us? No thanks! We'll just persist in thinking our selfish concerns now have no parallels in, oh, countless preventable tragedies we weep over in movie theatres.

Right now the news is providing amazing reports of social movements unfolding in the Middle East. If you are thrilled by the rhetoric, and support the rebels in the abstract, but wouldn't welcome the participants to sit at your dinner table, then you are a hypocrite of the highest order.

Yes, a large number of the refugees are "economic migrants." That means they are fleeing to find "food." Hundreds of years of analysis indicates that people who move to improve their status and secure the survival of their children tend to be diligent, hardworking, and grateful.

I surfaced from multiple conflicting deadlines long enough to prepare for the First Official Houseguest and noticed that I'm not responsible enough to own white towels.

These goods were purchased from Heal's when I moved in to the flat last September. I had never before owned quality towelling and couldn't have known what to expect, but I did anticipate they would remain dazzling and fluffy longer than five months. Especially since I was away for two of those months.

They are not tattered or dirty, they are just. . . vaguely not quite white.

How do people manage? Stateside friends reply "bleach" but I have never found the stuff here in the UK. Or at least, the stores I frequent stock only the colour safe powders, not the vats of industrial toxins so common in my homeland.

And if I could find pure liquid bleach I probably wouldn't use it, as my washing machine is one of those tiny all-in-one units located not very efficiently in the kitchen. The smell of a bleach cycle would be awful - and possibly dangerous. Can you mix bleach and integrated dryers? I don't think I want to know.

What a conundrum.

The fact that I am indulging in these thoughts is probably the most disturbing thing of all, as I have built my adult life on the premise that I do not cook or clean or care.

Why then have I become infested with concerns domestic?

Largely because this home is my own; it doesn't belong to anyone else, and so, like my boat, or the PDX office, it is a strictly controlled environment.

I lack all housewifely skills and aspirations but I am authentically obsessive compulsive. What is mine is not only mine, it is tidy. Twenty years of slovenly misery has been vanquished!

My house is clean, and will remain clean, no matter what the other residents think or feel or desire.

I never accomplish anything unless I have external motivation: a publisher, or a promise, or a legitimate need to earn money. Vanity and boredom might be sufficient motivations to play with words or tell a story, but I would never sit down and write without remunerative inspiration. I just can't - the words do not cooperate. I will happily tap and scratch away for years on projects that I never sell, or even show, but the intent from the first paragraph is always publication.

The point people often miss is that those of us who do this for a living have longer goals - one project may or may not be a "hit" but the career itself is cultivated by diligence.

I don't know any professional writers who, if they are telling the truth, function otherwise. Even if the pay is small or fame insignificant, they are either motivated by practical concerns - or they are not writers. The word is not a metaphysical demarcation. It is a job title.

Moreover, it is a job title I do not use unless forced. My youthful pretensions cooled well before my fifteenth birthday, and since then I have never understood why anyone capable of other work would want such a frightening, unstable career. I would rather have been a welder. Or ferry boat captain. Think of the uniforms!

George Orwell likened finishing a book to recovering from a long dreadful illness and that has certainly been my experience. Publishing Lessons in Taxidermy was harder than living through many of the dread experiences described therein.

I'm not exaggerating.

I rarely hang out with the people who would naturally read my work (blame geography) so there isn't much point in talking about it. What am I working on: magazine story, journal article, anthology, book? It doesn't matter. You wouldn't inquire if I were a proctologist, right?

The only important fact is that I work, every day, whenever and wherever I can scratch the time.

I was just offered £1,000 to write four twitter posts in praise of a product I have neither used nor even heard of.

Um. In a word: no.

When I mentioned this to family and friends they were baffled - why would I turn down something so easy and lucrative? The reaction went something like this: it would take you three minutes to write it, and the price per word rate is awesome. The task is, after all, just writing something for money - and that is your job. If you don't like the product, so what, think of it as fiction, and you are not opposed to reading or writing fiction, right?

Well, actually, accepting money to lie is not technically my job. And anyway, I wouldn't do it even if I loved the product. I accept samples, review copies, free tickets, trips, and sponsorship funding, but never with the guarantee that I will give positive reviews (or anything) in exchange.

Doing so is contrary to the ethics of my job and industry, though you might not think so given how standards have slipped in the last few years. It has become common practice to accept fees for placement, in part because internet sites are not exactly one thing or the other. But I run a magazine, in the old-fashioned sense, and I can't even accept many of the ads people want to place on hipmama.com. Why? Because they are antithetical to the point of the publication.

I am frequently offered 'advertorial' - sponsored editorials that glorify products or places - but I do not accept them, on principle, and I never will. There are very few magazines still operating with this principle, but I trudge along. I have also refused venture capital and other forms of investment, because doing so would have required a dissolution of the editorial perspective. When you take money, you give up power. I refuse, or rather, my price is higher than the market is willing to pay.

Because of this, despite our popularity and high traffic, we're lucky to make enough to cover operating expenses on the publication. I've made an executive decision that we operate in a principled fashion, never contaminated by lower impulses like greed, nor even a sensible acknowledgment of market forces. The point of the publication is to give marginalised people and ideas a venue, to create a public dialogue, to nurture communities. Not to make money. Though money is certainly required to keep the doors open, and I tend to rush from one crisis to another in the pursuit of sustainable financial models. That is just life, as it has always been and will remain.

My own income comes from freelance gigs, consulting, and book royalties, all of which is tricky at best. But my reputation is worth something tangible because it is the foundation on which I build the rest of the work. I am incredibly cautious about getting mixed up in magazine world scandals, because I plan to do this for a long time. I don't have an exit strategy, I'm not trying to get rich, I'm instead trying to strike a fine balance that allows me to keep working on my own stuff while funding the public projects.

These concerns look quaint and archaic when nearly everyone has capitulated to the allure of commercial web sites. Friends who are meticulous and passionate about consumer choices, who buy union cotton and fair-trade coffee and farmer's market vegetables, who would never shop at Wal-Mart or similar chains, see no problem in using Facebook. They treat it like a public utility, when in fact it is simply a scheme to make money for founders and investors.

Twitter in my opinion is worse, because the format solicits the most pithy of my friends to contribute their work - quips they would have been paid for until recently - for free. They are volunteering their own brilliance, in pursuit of what? Audience, attention? Well, good luck with that. I use the sites myself but remain aware of the hazards.

Twitter is not a public service project, or even a fun toy. It is a business and as such has the fundamental goal of translating commodities (in this case, you) into profits. Have you wondered how they manage it, since the site is blissfully simple and uncluttered with advertisements, surveys, special pleading, spam? Easy. They sell the data stream.

Your comments, observations, opinions, and concerns are collated and evaluated by investment banks and major multinational companies to track trends and build investment strategies. For every incidence of an activist or revolutionary achievement, you can bet with absolute certainty that some suit in a remote office is selling or buying stock as a direct consequence.

Twitter and Facebook might reunite you with friends from grade school, or allow your cohort to navigate a protest, but that is immaterial to investors. They don't care why you turn up, they only care that you do, in vast numbers, so they can decide what product to bet on next.

And this is all of course completely normal. Business is as business does. The exasperating part is the fact that many participants appear not to notice or care. Here is one small thought: if you "like" an independent product or publication or site, it is more helpful to actually use it, directly, than it is to chat about your appreciation on Facebook and Twitter.

If you adore a magazine or newspaper, please consider subscribing. Buy the books, records, t-shirts and paraphernalia offered by your favourite artists. Go to the live shows. If you can't afford that level of support, use their direct web sites, because that traffic is how we all sell ads, pitch projects, fund our work.

I've been doing this long enough that the whole thing just makes me shrug. I'm irritated but also idealistic. Commercial web sites come and go, according to their ability to make money. What is ascendant or sexy today might be gone tomorrow.

And like Samuel Johnson said way back in 1753:

General irregularities are known in time to remedy themselves. By the constitution of ancient Egypt, the priesthood was continually increasing, till at length there was no people beside themselves; the establishment was then dissolved, and the number of priests was reduced and limited. Thus among us, writers will, perhaps, be multiplied, till no readers will be found, and then the ambition of writing must necessarily cease.